Semi-Potent Steroids Treat Tight Foreskin Problem

Moderately potent topical steroids are just as effective as highly potent ones for treating phimosis and offer a lower risk of side effects, new research suggests. Phimosis is a condition in which the foreskin opening is too small for it to be pulled back over the head of the penis. Phimosis can affect 8 percent of boys between the ages of 6 and 7. Although phimosis can resolve by itself, it is often treated by circumcision, in which the foreskin is surgically removed. While circumcision is an effective treatment for phimosis, various complications can occur and topical steroid therapy has emerged as alternative. The British National Formulary and other groups have divided topical steroids into several potency categories. Most studies looking at these agents as a treatment for phimosis have included only ultra-high or high potency steroids. Thus, it is unclear if lower potency steroids could achieve the same results with a better side effect profile. To investigate, Dr. Chung Cheng Wang, from En Chu Kong Hospital in Taipei, Taiwan, and colleagues assessed the outcomes of 70 boys who were randomly assigned to receive topical therapy with betamethasone, a highly potent steroid, or with clobetasone, a moderately potent steroid. The treatment response rates in the two groups were not significantly different -- about 79 percent. The average drop in the phimosis severity score was also comparable in each group -- about 2.2. No significant adverse effects were seen in either group. Writing in the April issue of the Journal of Urology, the investigators say that when topical steroid application is attempted to treat phimosis, moderately potent steroids should be considered first to avoid adverse effects that could, in theory, occur with higher potency agents. SOURCE: Journal of Urology April 2005.